Injection Grouting & Concrete Repair Product Sales

Purchase Order Account Application NET15

NOTE: This application form is to apply for Purchase Order Account privileges. It should be noted that the credit account refered to in this application will be activated for large corporate agencies only, or invited customers who have developed a solid history with our company.

TERMS: NET 15 or NET28(special invitations only please).

If you already have an account with us, you can login at the login page.

Company Details

* Required information

Company Name:
Street Address:	*
City:	*
US State or Province:	*
Post Code (No Spaces):	*
Country:	*
Telephone Number:	*
Fax Number:
Credit Amount Requested : $	*
Length of time in business:	*
Company Type:	*
Number of employees:	*

Credit References: Give complete Name, Address, Phone Number, and Fax Number

Reference 1:	*	Address:	*
City:	*	Province/State:	*
Phone:	*	Fax:	*

Reference 2:	*	Address:	*
City:	*	Province/State:	*
Phone:	*	Fax:	*

Reference 3:	*	Address:	*
City:	*	Province/State:	*
Phone:	*	Fax:	*

Accounts Payable Contact:

Gender?:	Male Female *
First Name:	*
Last Name:	*
E-Mail Address:	*
Telephone Number:	*

Options

Newsletter:

Account Password

Password to use with this account No spaces:	*
Password Confirmation:	*

NOTE: It should be noted that the credit account refered to in this application will be activated for large corporate agencies only, or invited customers who have developed a solid history with our company.

TERMS:
NET15
Due to wide spread abuse of our credit account privileges (very late payments), we have been forced to now only offer NET15 (payment within 15 days), we hope to be able to change this in the future.
NET28: (by special invitation only)

A FINANCE CHARGE of 2% per month (APR 24%) will be added to all outstanding amounts after 15 or 28 days respectively from date of invoice.

If the applicant is a limited or incorporated entity, the person submitting this application hereby certifies that they have the legal authority to bind the applicant to the above listed conditions. It may be requested that a hard copy of this agreement that has been be signed and witnessed, be returned to our offices prior to activation of this account.

Credit Policy

I/We, the applicant agree to pay the account within the terms as stipulated on each invoice, and if not paid in accordance with such terms are then delinquent.

The applicant and each principal hereby authorizes River Rock Industries Corp. to collect Personal Information on the applicant and each principal and maintain files with such information for the purposes of assessing the risk of granting credit to the applicant and continuing to grant credit to the applicant from time to time and for collecting and receiving payment of all amounts owing to River Rock Industries Corp. from time to time from the applicant and-or each principal. The applicant and each principal hereby authorize River Rock Industries Corp. to share their personal information with credit reporting agencies and obtain reports containing personal information on the applicant and each principal from credit reporting agencies all for the purposes stated above or for any other connected business reason. You have rights to access and correction of your personal information by request in writing to River Rock Industries Corp.

If credit availability is granted by River Rock Industries, all decisions with respect to the extension or continuation of credit shall be at the sole discretion of River Rock Industries

If any account becomes in arrears and collection process becomes necessary, all amounts on the account become due and payable in full and River Rock Industries may suspend all further credit to the applicant indefinitely. River Rock Industries Corp. reserves the right to revoke credit privileges and close an existing account without notice.

While the applicant and each principal recognize they have the right to terminate their agreement to permit the collection of personal information by River Rock Industries Inc., such termination or (at the election of River Rock Industries Inc.), the failure of the applicant to pay amounts due and owing to River Rock Industries Inc. when required may at the election of River Rock Industries Inc. result in the cancellation of all credit terms, prior terms or arrangements with the applicant and River Rock Industries Inc. may call all amounts currently owing due and payable in full.

If any amounts are not paid within the agreed period, the submitter of this application agrees to pay a service charge, on such amounts, of 2 percent per month, being 24 percent per annum or the maximum permitted by Ontario law.

If the applicants account is placed in the hands of an outside agency for collection, the applicant agrees to pay reasonable attorney fees and collection costs, even though legal proceedings are not filed. If legal proceedings are filed, the amount of such reasonable attorney fees shall be fixed by the court in which the proceeding is filed, including any appeal therein.
The applicant agrees that this agreement shall be governed by and construed in accordance with the laws of the Province of Ontario, Canada. Jurisdiction and venue with respect to any suit in connection with the Agreement shall reside in the City of Barrie, Province of Ontario.

The applicant and each principal have read and understand the terms of credit as indicated above and agree to abide by them. Each principal is agreeing on behalf of the applicant as an authorized signatory and also in his/her personal capacity if the applicant is a sole proprietor. The applicant and principals agree to the terms and conditions attached hereto and further THE PRINCIPALS HEREBY UNCONDITIONALLY GUARANTEE THE PAYMENT OF ALL AMOUNTS OWING BY THE APPLICANT TO River Rock Industries Inc. FROM TIME TO TIME IN ACCORDANCE WITH THE TERMS OF THE GUARANTEE SET OUT IN THE TERMS AND CONDITIONS. THE CREDIT GRANTED IS FOR BUSINESS AND NOT PERSONAL, FAMILY, HOUSEHOLD OR FARMING PURPOSES.

The applicant is hereby advised that River Rock Industries intends to refer to a report from a credit reporting agency in connection with the opening of a new account proposed to be entered into by the applicant with River Rock Industries Corp. and the applicant consents to the obtaining of such information from his present or future employer, credit reporting agency, or any person as River Rock Industries Corp. may require at any time in connection with any transaction entered into between the same.

You may at any time complete the product purchases of your choice using the many other payment options available through this fine online store.

Authorization is granted to make credit inquires with the references listed above.

BY CLICKING THE SUBMIT BUTTON BELOW I HAVE READ THE ABOVE AND AGREE TO COMPLY WITH THE TERMS OF PAYMENT AND OTHER STATED CONDITIONS.Processing of your application will begin promtly. Information regarding the status of your application can be obtained by calling 1-866-640-3476.

Rod Johnson
President